Step 1 of 6 - Section A - Contact Information

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If you're an existing BVT tenant or homeowner, it’s important for you to keep us informed of any changes to your details. This helps us ensure we can contact you if we need to and that we’re communicating in the best possible way.

The personal details that you provide in this form will be processed in line with our Fair Processing Notice. To read our Fair Processing Notice in full, please visit the Fair Processing Notice page of this website – a link to which can be found in the footer.

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE A CURRENT BVT TENANT OR BVT HOMEOWNER. THIS IS NOT AN APPLICATION FORM FOR HOUSING. FOR HOUSING ENQUIRIES PLEASE VISIT THE OUR HOMES SECTION OF THE WEBSITE

If you were advised to complete this form by a BVT staff member please insert their name below.

Next of Kin Contact Details

Are you happy for us to contact your Next of Kin in case of an emergency?

Yes

No

Communication Preferences

How would you prefer to receive written communication?*

Letter

Email

Do you have any problems reading written communication?

Yes

No

If YES, please provide details

Do you have any problems communicating on the telephone?

Yes

No

If YES, please provide details

Do you need any information we send to you in a different format?

Yes

No

If YES, which format?

Large Print

Audio CD

Braille

If given a choice, would you prefer the printed information we give you in a different language?

Yes

No

If YES, which language do you prefer?

Are you digitally capable?*

Yes

No

If yes, do you have the ability to go online and connect to the internet?

Yes

No

Are you happy for us to contact you by text message, where appropriate? (for example, reminding you of an appointment)

Yes

No

Demographic Information

What is your gender?

Male

Female

Transgender

What is your date of birth?

DD

MM

YYYY

Do you have a long term illness, health problem or disability which limits your daily activities or the work that you can do (including any problems with old age)?

Yes

No

Prefer Not to Say

If YES, what is the nature of the illness or disability?

Mobility

Visual Impairment

Hearing Impairment

Learning Disability

Mental Health

Prefer not to say

Other (please provide details)

What is your religion or beliefs?

None

Agnostic

Christian (all)

Humanist

Muslim

Atheist

Buddhist

Hindu

Jewish

Sikh

Prefer Not to Say

Other

Other (please provide details)

What is your economic status?

Full-time work

Job Seeker

Retired

Part-time work

Not seeking work

Student

Unable to work due to disability/illness

Prefer Not to Say

Other

Other (please provide details)

What is your ethnic origin?

Asian British

Indian

Bangladeshi

Pakistani

Chinese

Black British

Caribbean

African

Arab

Gypsy/Romany/Traveller

European

White and Black Caribbean

White and Black African

White and Asian

White British

White Irish

Prefer Not to Say

Other

Other (please provide details)

How would you describe your sexual orientation?

Heterosexual

Gay man

Lesbian

Bisexual

Prefer Not to Say

Other

Other (please provide details)

Demographic Information

To be completed by the Joint Client/Partner

What is your relationship to the Main Client?

Spouse/Civil Partner

Partner

Child

Other

What is your gender?

Male

Female

Transgender

What is your date of birth?

DD

MM

YYYY

Do you have a long term illness, health problem or disability which limits your daily activities or the work that you can do (including problems with old age)?

Yes

No

Prefer Not to Say

If YES, what is the nature of the illness or disability?

Mobility

Visual Impairment

Hearing Impairment

Learning Disability

Mental Health

Prefer not to say

Other (please provide details)

What is your religion or beliefs?

None

Agnostic

Christian (all)

Humanist

Muslim

Atheist

Buddhist

Hindu

Jewish

Sikh

Prefer Not to Say

Other

Other (please provide details)

What is your economic status?

Full-time work

Job Seeker

Retired

Part-time work

Not seeking work

Student

Unable to work due to disability/illness

Prefer Not to Say

Other

Other (please provide details)

What is your ethnic origin?

Asian British

Indian

Bangladeshi

Pakistani

Chinese

Black British

Caribbean

African

Arab

Gypsy/Romany/Traveller

European

White and Black Caribbean

White and Black African

White and Asian

White British

White Irish

Prefer Not to Say

Other

Other (please provide details)

How would you describe your sexual orientation?

Heterosexual

Gay man

Lesbian

Bisexual

Prefer Not to Say

Other

Other (please provide details)

Other Household Members

Please provide details of any other household member/s living at your address - excluding any joint client/partner whose details you have already provided in Section D. To add multiple household members, click on the + button

There are no other household members living at this address

Relationship to You

Full Name

Date of Birth

Ethnicity

Gender

Economic Status

Please detail below if any member of the household, named above, has a disability, health problem or a limiting long term illness:

Mobility

Visual Impairment

Hearing Impairment

Learning Disability

Mental Health

Other

Please provide details of any household member who no longer lives at your address

Full Name

Date of Birth

Why is this person no living at your address?

Declaration

Full name of Main Client

Date

DD

MM

YYYY

If this form has been completed on behalf of the Main Client, please provide the details of the individual completing the form below: